Diabetes knowledge deficits in adolescents and young adults with type 1 diabetes mellitus
A Khamis, S Hoashi, G Duffy, R Forde, N Vizzard, P Keenan, D Cregan, RGR Firth & BT Kinsley
All adolescent and young adult T1DM attending our clinic, based in a university teaching hospital are reviewed three monthly and receive individual advice from dietician, nurse educator and consultant diabetologist at each visit. We aimed to identify deficits in diabetes related knowledge and assess diabetic control in this population.
Subjects were asked to complete ADKnowl(Audit of Diabetes Knowledge) Questionnaire. Demographic data and measures of glycaemic control were obtained from the patient records at the same visit.
Data is presented on 41 subjects with T1DM (23 female, 18 male). Mean age was 18.7 ± 1.9 yrs. 13 were school going, 18 attending 3rd level and 10 were in employment. DM duration 8.5 ± 4.5 years, HbA1c of 8.9 ± 1.9% (range 5.7-13.0 %) [Ref. range 3.3-5.9%]. 9 (22%) required admission with diabetic emergency. 10 (24.4%) had systolic BP >130mmHg. Two have known nephropathy, and one has retinopathy. 31 (75.6%) were regular alcohol drinkers and 5 (12.2%) were smokers. 7 from 22 females (31.8%) were on OCP.
Deficits were identified in diabetes knowledge (<50% correct): in relation to insulin dosage adjustment during illness, suitability of food choices, frequency of need for ophthalmology review and foot care. No deficit was evident in relation to glycaemic control, hypoglycaemia, exercise effects, alcohol and cigarette consumption.
Knowledge deficits were identified in this group of subjects. Certain deficits such as management of sick days may have serious short-term consequences. Glycaemic control in this diabetic population is similar to published international data but does not correlate with diabetes knowledge as assessed by ADKnowl. Diabetes education can be focused on knowledge deficits but knowledge does not appear to correlate with glycaemic control.